Essential Repairs Allowance Refund Request Form

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Essential Repairs Allowance Refund Request Form

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Contractor name(Required)

Description of repair/s(Required)

Date work was complete(Required)

Please upload the invoice here(Required)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 40 MB, Max. files: 2.

Value of work (including VAT)(Required)

Value of the refund requested (this will be the same as the value of the works as long as you have sufficient allowance left, if you do not have the full amount then this should be the value of your remaining allowance)(Required)

I confirm that the works completed were approved by Paradigm prior to them being completed, they are the same works and the same value and completed by the same TrustMark contractor on the Essential Repairs Allowance Application Form.(Required)

Yes

Account information

Please choose one and tick the relevant box:

I pay Paradigm by direct debit normally and I am happy to be re-imbursed to the account the direct debit is taken from.(Required)

Yes

No, I would like to be re-imbursed to a different account

Account name

Account Number

Account Sort Code

Bank/building society name